This chapter focuses on individuals with emotional or behavioral disorders. Identifying these disorders is difficult because behavior is multidimensional and influenced by culture and social situations. Definitions of emotional or behavioral disorders from the Federal government as well as an advocacy group for individuals with emotional or behavioral disorders are presented. Different classification systems for emotional or behavioral disorders that are based on clinical observations or statistics are presented as is a history of the field. Biological and psychosocial risk factors for emotional and behavioral disorders are reviewed as is the research on resiliency, and prevention, and positive behavior supports. The learning, social, and language/communication characteristics of individuals with emotional or behavioral disorders are summarized.  Attention is given to the assessment of individuals with these disorders. The educational, physical environment, academic, instructional, and other interventions used with these students are discussed. Information useful for working with young children and adults with emotional or behavioral disorders and the importance of family-centered interventions are presented along with diversity issues, technology usage, trends, issues, and controversies such as the effectiveness of RTI and the use of restraint and/or seclusion with individuals with emotional or behavioral disorders. 

Learning Objectives:

• Outline the issues surrounding our understanding of emotional or behavioral disorders.
• Define socially maladjusted and conduct disorders.
• Distinguish between clinically derived and statistically derived systems for classifying emotional or behavioral disorders.
• Explain how society has historically dealt with persons with emotional or behavioral disorders.
• Identify biological and psychosocial risk factors of emotional or behavioral disorders.
• List the learning and social characteristics typical of students who exhibit emotional or behavioral disorders.
• Describe contemporary approaches for assessing pupils with emotional or behavioral disorders.
• Provide examples of academic and behavioral interventions often used with individuals with emotional or behavioral disorders.
• Define time management, transition management, proximity and movement management, and classroom arrangement.
• Summarize educational services for persons with emotional or behavioral disorders across the life span.

Lecture Outline:

1. Defining Emotional or Behavioral Disorders
   
   1. Federal definition of emotional disturbance: “a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance”
      
      1. Inability to learn not explained by other factors
      2. Inability to have interpersonal peer relationships
      3. Inappropriate behavior or feelings under normal circumstances
      4. Pervasive mood of depression or unhappiness
      5. Tendency to develop physical symptoms or fears
   2. Since the passage of PL 94-142 in 1975, only two changes have been made to this definition:
      
      1. Autism became a separate disability category in 1990
      2. Prior to 1997, the term used was serious emotional disturbance.
   3. CCBD definition
      
      1. Behavioral or emotional responses in school programs so different from appropriate age, cultural or ethnic norms that the responses adversely affect educational performance
      2. More than a temporary expected response to stressful events in the environment
      3. Consistently exhibited in two different settings at least one of which is school
      4. Unresponsive to direct intervention applied in general education or general education interventions would be ineffective
   4. There are four common characteristics to most definitions of emotional and behavioral disorders:
      
      1. Frequency
      2. Intensity
      3. Duration
      4. Age-appropriateness
   5. Disturbed and disturbing behaviors based on context
   6. Typical and atypical behavior
   7. Variability in cultural and social expectations for behavior.
   8. Classification systems
      
      1. DSM-V
      2. Externalizing behaviors
      3. Internalizing behaviors
      4. Quay and Peterson’s Dimensions of Problem Behaviors
         1. Conduct Disorder
         2. Socialized Aggression
         3. Attention Problems/Immaturity
         4. Anxiety/Withdrawal
         5. Psychotic Behavior
         6. Motor Tension Excess
2. Brief History of the Field
   
   1. Historical relationship between insanity and intellectual disability: In 1886, a legal distinction was made between mental illness and intellectual disability. Until then, the two fields were viewed as synonymous.
   2. The Mental Hygiene Movement: Influenced the study of children and youth with emotional disturbances in attempt to provide formal education and treatment.
   3. Early research on emotional or behavioral disorders: Schools and hospitals developed that were devoted to the care and education of children with emotional or behavioral disorders.
   4. The birth of a specialized field of study: 1940-1960 marked the birth of special education for children with emotional or behavioral disorders as a specialized field of study.
   5. The emergence of conceptual models: In the 1960s, research began to appear in professional literature regarding classroom programs, practices, and curricula for children with emotional or behavioral disorders. Several models emerged to describe emotional or behavioral disorders:
      
      1. Behavioral
      2. Psychodynamic
      3. Psychoeducational
      4. Ecological
      5. Humanistic
      6. Biogenic
3. Prevalence of Emotional and Behavioral Disorders
   
   1. Exact prevalence may be impossible to determine due to a variety of identification procedures and lack of consensus regarding what constitutes acceptable behavior.
   2. Sixth largest category for children this age
   3. This disability category may be the most under identified category due to social stigma and variability in state’s identification procedures and definitions
4. Suspected Etiologies of Emotional and Behavioral Disorders
   
   1. Biological risk factors
      
      1. Genetic influence: autism, bipolar disorder, schizophrenia, obsessive-compulsive disorder, Tourette’s syndrome, depression
      2. Biological factors: infection, lead poisoning, toxin exposure
   2. Psychosocial (environmental) risk factors
      
      1. Parental discord, poverty, maltreatment (abuse, neglect), rejection, poor health care, poor nutrition
5. Prevention of Emotional or Behavioral Disorders
   
   1. Research on resiliency
      
      1. Resilient children do not develop emotional or behavioral disorders even under the most adverse circumstances. They display four characteristics: they are socially competent, have excellent problem-solving skills, are autonomous, and develop clear goals and have high aspirations.
   2. Research on positive behavioral support
      
      1. Positive behavioral supports are strategies that proactively reinforcement positive behaviors rather than focusing on punishing negative behaviors.
6. Characteristics of Students with Emotional or Behavioral Disorders
   
   1. Learning characteristics
      
      1. Range of intellectual abilities, chronic school failure, absenteeism, grade retention, school dropout
   2. Social characteristics
      
      1. Difficulty building and maintaining relationships, aggressive behavior, experience rejection, externalizing and internalizing behaviors
   3. Language/communication characteristics
      
      1. Deficits in the areas of pragmatics, receptive, and expressive language and limited or inappropriate language use
7. Classroom Strategies
   
   1. Assessing Students with Emotional or Behavioral Disorders
      
      1. Interviews with student, parents, and teachers
      2. Examination of student records
      3. Parent, teacher, and student rating scales
      4. Observations in multiple natural settings
      5. Medical evaluations
      6. Standardized academic and IQ testing
      7. Functional behavioral assessment (FBA)
      8. Strength-based assessments
      9. Other measures as appropriate
   2. Physical Environment Interventions
      
      1. Time management
      2. Transition management
      3. Proximity and movement management
      4. Classroom arrangement
      5. Classroom ambience
   3. Academic and Instructional Interventions
      
      1. Academic curriculum
      2. Instructional delivery
      3. Mnemonic strategies
      4. Self-monitoring strategies
      5. Curriculum-based measurement
      6. Content enhancements
   4. Behavioral and Cognitive-Behavioral Interventions
      
      1. Social skills training
      2. Interpersonal problem solving
      3. Conflict resolution
      4. Provision of related services
      5. Crisis prevention and management programs/plans
8. Services for Young Children with Emotional or Behavioral Disorders
   
   1. A difficult temperament and early antisocial behavior appear to be significant indicators of later emotional or behavioral disorders. This is a persuasive argument for early intervention programs.
9. Transition to Adulthood
   
   1. Emotional or behavioral disorders are a predictor for school failure, delinquency, adult psychiatric problems, and substance abuse
   2. Absence of research on transition planning for adolescents with emotional or behavioral disorders
   3. Interventions, such as wrap-around programs, should be started early and may need to be maintained throughout life
   4. Support to graduate from high school and pursue higher education
10. Adults with Emotional or Behavioral Disorders
    
    1. Adults with emotional or behavioral disorders are no longer protected by IDEA; they are protected by Section 504 of the Rehabilitation Act and the Americans with Disabilities Act (ADA) that ensures reasonable accommodations in postsecondary education and in the workplace.
    2. Adults with emotional or behavioral disorders may need supports and services to successfully complete postsecondary training programs and obtain competitive employment.
11. Family-Centered Interventions
    
    1. Family-centered approach to planning for children with emotional or behavioral disorders supports the family’s needs.
    2. Recognize the family’s strengths and concerns
    3. Home-school collaboration is essential
12. Issues of Diversity
    
    1. Overrepresentation of African-American males in special education programs for children with emotional or behavioral disorders. Over reliance on standardized tests that are not sensitive to cultural differences may impact identification of minority students.
    2. Female students are underrepresented in special education programs for children with emotional or behavioral disorders. Female students with emotional or behavioral disorders tend to exhibit internalizing disorders that may go unnoticed as they tend not to be disruptive.
13. Technology and Individuals with Emotional or Behavioral Disorders
    
    1. Content area assistive technologies
    2. Self-management
    3. Self-monitoring
    4. Technology as a reinforce for behavior intervention plans
14. Trends, Issues, and Controversies
    
    1. Use of RTI and other prevention models
    2. Use of restraint and seclusion